MEDICARE: MONIKA KUMANOVA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD451181	PA

General Provider Information

NPI Number	:	1568773042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIKA KUMANOVA M.D.

Provider Business Mailing Address
First Line	:	1840 SOUTH ST
Second Line	:	TUTTLEMAN BUILDING
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-7411
Country	:	US
Telephone Number	:	215-893-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 SOUTH ST
Second Line	:	TUTTLEMAN BUILDING
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-7411
Country	:	US
Telephone Number	:	215-893-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	07/17/2014

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